Hahneman Ki Aawaz posted on 16.08.2019
Introduction – The term ‘ankylosing’ has been derived from the Greek word, ‘ankylos’ which means stiffening of joint, while ‘spondylos’ means vertebra.1 Ankylosing spondylitis is characterized by a chronic inflammatory arthritis predominantly affecting the sacro-iliac joints and spine which can progress to bony fusion of the spine.2
Aetiology – The aetiology of ankylosing spondylitis is unknown, it primarily affects the axial skeleton. 90-95% of patients with ankylosing spondylitis are positive for human leukocyte antigen B27 (HLA-B27). The age of onset is second or third decade of life with a male:female ratio of about 3:1 3
Clinical presentation – low Back pain and stiffness, peripheral enthesitis and arthritis and constitutional and organ specific extra articular menifestations are general features of ankylosing spondylitis.
X ray changes are characteristic but may take years to develop. Sacroilitis is often the first abnormality.
Bamboo spine – Lateral thoracolumber spine X ray may show anterior ‘squaring’ of vertebrae due to erosion and sclerosis of the anterior corners and periostitis of the waist. Bridging syndesmophytes are fine and symmetrical and follow the outermost fibers of the annulus. Ossification of the anterior longitudinal ligament and facet joint fusion may also be visible. The combination of these features may result in the typical ‘bamboo’ spine.2
ESR and CRP are usually raised. RF and other autoantibodies are usually negative.
Management – The aims are to relieve pain and stiffness, maintain a maximal range of skeletal mobility and avoid the development of deformities. Patient should be taught to perform daily back extension exercise. Poor posture must be avoided.
Ankylosing spondilitis and its homoeopathic management 4 –
Aesculus hipp. Spine feels weak; back and legs give out. Backache affecting sacrum and hips; worse walking or stooping.
Agaricus mus. Spine sensitive to touch; worse in dorsal region. Lumbago; worse in open air.
Argentums met. Severe backache; must walk bent with oppression of chest.
Cimicifuga Stiffness and contraction in the neck and back. Intercostal rheumatism. Rheumatic pain in muscles of back and neck. Pain in the lumber and sacral region, down the thighs and through the hips.
Kali carb Lumbosacral region feels weak. Stiffness and paralytic feeling in back. Burning in spine. Lumbago with sudden sharp pains extending up and down the back and extending to the thighs.
Kalmia Pain down the back as if it would break; in localized region of the spine; through the shoulders. Lumber pain of nervous origin.
Natrium mur Pain in back with a desire for some firm support.
Rhustox Pain and stiffness in lumbosacral region; better motion or lying on something hard; worse while sitting.
1. Khan MA. Ankylosing Spondylitis: Clinical features Rheumatology. 3rd ed.London: pp.1423-27
2. Colledge NR,Walker BR, Ralston SH, editor. Davidson’s Principles and Practice of Medicine.21st ed.2010.
3. Braun J, Bollow M, Remlinger G, Eggens U, Rudwaleit M, Distler A, et al. prevalence of spondylopathies in HLA-B27 +ve and –ve blood donors. Arthritis Rheum. 1998;41:58-67
4. Boericke W. Pocket manual of homoeopathic materia medica and repertory. New Delhi : B Jain Publishers (P) Ltd;1998.
About the Author – Dr. Gunjan Pandey, M.D.(Hom.) Part II from Repertory branch in Dr.M.P.K. Homoeopathic Medical college, Hospital and Research centre a constituent college of Homoeopathy University, Jaipur, Rajasthan – 302029